Objective: The goal of this study was to evaluate the use of psychotropic medication as needed (pro re nata or prn) in children and adolescents in a psychiatric hospital and those children in the residential treatment program. Methods: The pro re nata medication use of all 152 unduplicated patients admitted to Hawthorn Children’s Psychiatric Hospital in St. Louis, Missouri (USA) beginning in April 2015 through March 2016 were reviewed for this study. The medication orders of all patients are placed electronically. Reports on prn medication use at the facility were obtained from the electronic medication administration (e-MAR) utilizing the MetaCare software. Results: In this study, gender, race, and health insurance coverage had no statistically significant association with prn medication usage. However, the child’s age did have a statistically significant association (p<0.01) with prn medication usage. Inpatients younger in age were more likely to have received prn medications during their hospitalization. 

Conclusion: Due to little empirical evidence for prn’s in younger children and these results show an increased use in younger patients, our data suggests that prn’s be limited when treating these patients. This data also endorses behavioral treatments to be utilized before a prn is administered.